Paroxismal non-kinesigenic dyskinesia and hemidystonia associated with silent celiac disease

• Published in: Clinical neurology and neurosurgery Vol. 188; p. 105586
• Main Authors: Bago Rožanković, Petra, Rožanković, Marjan, Romić, Zrinka Čolak, Bašić, Silvio
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-01-2020; Elsevier Limited
• Subjects: Alcohol; Ataxia; Autoimmune diseases; Celiac disease; Celiac Disease - complications; Celiac Disease - diagnosis; Celiac Disease - diet therapy; Celiac Disease - physiopathology; Chorea - diet therapy; Chorea - etiology; Chorea - physiopathology; Clinical presentation; Consciousness; Diet; Diet, Gluten-Free; Disease; Dyskinesia; Exercise; Female; Genetic disorders; Gluten; Humans; Immunoglobulins; Metabolism; Movement disorders; Neurology; Patients; Physical fitness; PNKD (paroxysmal non-kinesigenic dyskinesia); Proteins; Thyroid gland; Undiagnosed Diseases; Urine; Young Adult; Celiac disease; PNKD (paroxysmal non-kinesigenic dyskinesia); Clinical presentation
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2019.105586

•Celiac disease can be presented with paroxismal non-kinesigenic dyskinesia (PNKD).•Unexplained movement disorder should be tested on gluten sensitivity.•Gluten free diet is potential terapy for PNKD associated with gluten sensitivity.
Paroxismal non-kinesigenic dyskinesia (PNKD) is a rare movement disorder manifesting as choreatic/dystonic movements, usually lasting from minutes to up to 4 h, with perserved consciousness during attacks. Primary PNKD are idiopathic or genetic disorders while secondary PNKD are associated with various neurologic and medical conditions. We present a case with PNKD and right sided hemidystonia in association with celiac disease, responsive to gluten-free diet, not previously reported in available literature.
In conclusion, diagnostic tests for celiac disease should be a part of etiological investigations in patients with otherwise unexplained movement disorders including PKND. Gluten free diet could produce a favorable clinical response in those patients.